Nicole M Iwanowski, OTR/L, CLT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4230026 Issued in WI

Practice address

10222 74TH St
Suite 211
Kenosha, WI 53142-6810

Phone

(262) 925-5020

Fax

(262) 925-5021

NPI assigned

Aug 30, 2006

Last updated

Oct 19, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Nicole M Groppi Former name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Orthopedic Specialty Hospital, LLCGroup PAC ID 7113078833, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midwest Orthopedic Specialty Hospital, LLC

  • Orthopaedic Surgery Physician
  • Franklin, WI
  • NPI 1275127375
  Medicare reassignment Care Compare group NPD
• Advantage Physical Therapy & Sports Rehab, LLC

  dba CORA Physical Therapy - Burlington

  • Rehabilitation Clinic/Center
  • Burlington, WI
  • NPI 1881773463
  Medicare reassignment NPD
• Advantage Physical Therapy & Sports Rehab, LLC

  dba CORA Physical Therapy - Racine

  • Rehabilitation Clinic/Center
  • Mount Pleasant, WI
  • NPI 1821669748
  NPD
• Advantage Physical Therapy & Sports Rehab, LLC

  dba CORA Physical Therapy - Hayward

  • Rehabilitation Clinic/Center
  • Hayward, WI
  • NPI 1902556012
  NPD
• Midwest Orthopedic Specialty Hospital, LLC

  • Rehabilitation Clinic/Center
  • Milwaukee, WI
  • NPI 1407508567
  NPD
• Midwest Orthopedic Specialty Hospital, LLC

  • Durable Medical Equipment & Medical Supplies
  • Muskego, WI
  • NPI 1962238113
  NPD
• Sports Physical Therapy & Rehab Specialists, S.C.

  dba Athletico Physical Therapy

  • Physical Therapist
  • Kenosha, WI
  • NPI 1326150624

  Occupational Therapist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1295844603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 52ND ST",
            "address_2": "SUITE 240",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531403423",
            "telephone_number": "262-925-5004",
            "fax_number": "262-925-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10222 74TH ST",
            "address_2": "SUITE 211",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531426810",
            "telephone_number": "262-925-5020",
            "fax_number": "262-925-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWANOWSKI",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "OTR/L, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4230026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295844603",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11781771",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GROPPI",
            "middle_name": "M",
            "credential": "OTR/L, CLT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Inspire Home Health LLC
• Interconnections, SC
• Nancy M Iuliano, P.T.
• Yelena Ivanova
• Jaya V Iyer, M.D.
• Mehran Jabbarzadeh, MD
• Micelle Lynn Jabczynski, M.S. CCC-SLP
• Jenell Diane Jackley, CPNP
• Christopher D. Jackson, LPC

• Occupational Therapist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.